BackgroundLong patient-clinic encounter time is typical of many hospital general outpatient departments (OPD) in Nigeria.ObjectivesThe objectives of our study were to determine the time spent by patients at the service points in the general OPD of the National Hospital Abuja (NHA), to establish the perception of patients regarding the patient–clinic encounter time, and to describe the level of satisfaction of patients with the services received.MethodsA cross-sectional study was conducted at the general OPD of the NHA. Information relating to the time spent at the various service points amongst others were obtained from 320 randomly selected patients using a patient administered validated questionnaire.ResultsTwo hundred and seventy (84.4%) patients responded adequately and were analysed. The median patient–clinic encounter time was 2.7 hours (range 0.2–7.2 hours). The long patient–clinic encounter time was accounted for mainly by the waiting time to see a doctor which was a median of 1 hour (range 0–5.6 hours) and time spent at the medical records with median of 0.5 hours (range 0–5 hours). There was a significant relationship between a short waiting time as perceived by patients, clinic visit encounters where patients’ expectations were met or surpassed, and overall patient satisfaction with the clinic visit encounter (p < 0.001).ConclusionReduction in patient–clinic encounter time and meeting patients’ pre-visit expectations could significantly improve patient satisfaction after clinic visit encounter at the general OPD of NHA.

BackgroundMortality amongst in-hospital patients bitten by carpet viper in northern Nigeria has reduced, related to use of a monospecific ovine Fab snake antivenom. However, many victims survive with temporary or permanent morbidity.ObjectivesStudy objectives were to: (1) determine and score the morbidity caused by carpet viper bite; and (2) find the relationship between bite-to-hospital time and morbidity amongst victims of carpet viper bite.MethodA prospective study was conducted in a rural hospital in north-central Nigeria. The morbidities scored were oedema, tenderness, prolonged whole-blood clotting time, blister, ulcer, need for blood transfusion, coma, hypotension, convulsion, length of hospital stay, need for disarticulation, and need for skin graft. A score of one was given to each objective sign. The bite-to-hospital time of 233 subjects was obtained. Descriptive and inferential statistical analysis was done.ResultsMost of the subjects (150 or 64%) came to the hospital within 6 hours of the snake bite, with 2 (1%) arriving within 1 hour. The median bite-to-hospital time was 5 hours, with a range of 0.5–216 hours. Major morbidities were oedema, seen in 212 (91.0%; 95% CI 86.6–94.3%); incoagulable blood, seen in 205 (88%; 95% CI 83.1–91.9%), and tenderness, seen in 201 (86.3%; 95% CI 81.2–90.4%). The mean morbidity score was 8 ± 4. For every unit increase in logged bite-to-hospital time, the morbidity score increased by 1.85 (p < 0.001).ConclusionMorbidity caused by carpet viper bite is high in Zamko, north-central Nigeria, and correlates with increasing bite-to-hospital time.

BackgroundWith globalization and rapid urbanization, demographic and epidemiologic transitions have become important determinants for the emergence of cardiovascular disease (CVD).ObjectiveTo estimate the prevalence of CVD risk factors in adult out-patients attending general practice and non-specialist clinics in urban and rural Nigeria.MethodsAs part of the Africa and Middle East Cardiovascular Epidemiological (ACE) study, a cross-sectional epidemiologic study was undertaken for the presence of hypertension, diabetes mellitus, dyslipidemia, obesity, smoking and abdominal obesity in Nigeria.ResultsIn total, 303 subjects from 8 out-patient general practice clinics were studied, 184 (60.7%) were female and 119 (39.3%) were male. Mean age was 42.7±13.1 years; 51.8% were aged <45 years; 4% ≥65 years. Over 90% of subjects had ≥1 of 6 selected modifiable cardiovascular risk factors: 138 (45.6%) had 1–2; 65 (21.5%) had 3; 60 (19.8%) had 4; and 11 (3.6%) had 5 concurrent risk factors. Screening identified 206 subjects (68.0%) with dyslipidemia who did not have a prior diagnosis.ConclusionCardiovascular risk factors are highly prevalent in Nigerian subjects attending out-patient clinics. Moreover, many subjects were undiagnosed and therefore unaware of their cardiovascular risk status. Opportunistic screening alongside intensive national, multisectoral education or risk factor education is needed, should be scaled up nationwide and rolled out in both urban and rural communities in Nigeria.

Background: Malaria diagnosis using microscopy is currently the gold standard. However, malaria rapid diagnostic tests (mRDTs) were developed to simplify the diagnosis in regions without access to functional microscopy.Aim: The objective of this study was to compare the diagnostic accuracy of mRDT CareStatTM with microscopy.Setting: This study was conducted in the paediatric primary care clinic of the Federal Medical Centre, Asaba, Nigeria.Methods: A cross-sectional study for diagnostic accuracy was conducted from May 2016 to October 2016. Ninety-eight participants were involved to obtain a precision of 5%, sensitivity of mRDT CareStatTM of 95% from published work and 95% level of confidence after adjusting for 20% non-response rate or missing data. Consecutive participants were tested using both microscopy and mRDT. The results were analysed using EPI Info Version 7.Results: A total of 98 children aged 3–59 months were enrolled. Malaria prevalence was found to be 53% (95% confidence interval [CI] = 46% – 60%), whilst sensitivity and specificity were 29% (95% CI = 20% – 38%) and 89% (95% CI = 83% – 95%), respectively. The positive and negative predictive values were 75% (95% CI = 66.4% – 83.6%) and 53% (95% CI = 46% – 60%), respectively.Conclusion: Agreement between malaria parasitaemia using microscopy and mRDT positivity increased with increase in the parasite density. The mRDT might be negative when malaria parasite density using microscopy is low.